TY - JOUR
T1 - Association between neighborhood-level socioeconomic deprivation and incident hypertension
T2 - A longitudinal analysis of data from the Dallas heart study
AU - Claudel, Sophie E.
AU - Adu-Brimpong, Joel
AU - Banks, Alnesha
AU - Ayers, Colby
AU - Albert, Michelle A.
AU - Das, Sandeep R
AU - de Lemos, James A
AU - Leonard, Tammy
AU - Neeland, Ian J
AU - Rivers, Joshua P.
AU - Powell-Wiley, Tiffany M.
N1 - Funding Information:
The Powell-Wiley research group is funded by the Division of Intramural Research of the National Heart, Lung, and Blood Institute and the Intramural Research Program of the National Institute of Minority Health and Health Disparities at the National Institutes of Health. This research is also supported by the National Institutes of Health Undergraduate Scholarship Program via funding for Joel Adu-Brimpong and the U.S. Health Resources and Services Administration (HRSA), D34HP16299 (Dr. Marquetta Faulkner, PI) for Alnesha Banks. Sophie E. Claudel is supported by the NIH Medical Research Scholars Program, a public-private partnership supported jointly by the NIH and generous contributions to the Foundation for the NIH from the Doris Duke Charitable Foundation, the American Association for Dental Research, the Colgate-Palmolive Company, Genentech, Elsevier, and other private donors. The DHS was funded by a grant from the Donald W. Reynolds Foundation. This work was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001105 to the University of Texas Southwestern Medical Center. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institute of Minority Health and Health Disparities; the National Institutes of Health; the U.S. Department of Health and Human Services or HRSA. The authors are solely responsible for the design and conduct of this study, all study analyses and drafting and editing of the paper.
Publisher Copyright:
© 2018
PY - 2018/10
Y1 - 2018/10
N2 - Background: Cardiovascular disease is a leading economic and medical burden in the United States (US). As an important risk factor for cardiovascular disease, hypertension represents a critical point of intervention. Less is known about longitudinal effects of neighborhood deprivation on blood pressure outcomes, especially in light of new hypertension guidelines. Methods: Longitudinal data from the Dallas Heart Study facilitated multilevel regression analysis of the relationship between neighborhood deprivation, blood pressure change, and incident hypertension over a 9-year period. Factor analysis explored neighborhood perception, which was controlled for in all analyses. Neighborhood deprivation was derived from US Census data and divided into tertiles for analysis. Hypertension status was compared using pre-2017 and 2017 hypertension guidelines. Results: After adjusting for covariates, including moving status and residential self-selection, we observed significant associations between residing in the more deprived neighborhoods and 1) increasing blood pressure over time and 2) incident hypertension. In the fully adjusted model of continuous blood pressure change, significant relationships were seen for both medium (SBP: β = 4.81, SE = 1.39, P =.0005; DBP: β = 2.61, SE = 0.71, P =.0003) and high deprivation (SBP: β = 7.64, SE = 1.55, P <.0001; DBP: β = 4.64, SE = 0.78, P <.0001). In the fully adjusted model of incident hypertension, participants in areas of high deprivation had 1.69 higher odds of developing HTN (OR 1.69; 95% CI 1.02, 2.82), as defined by 2017 hypertension guidelines. Results varied based on definition of hypertension used (pre-2017 vs. 2017 guidelines). Conclusion: These findings highlight the potential impact of adverse neighborhood conditions on cardiometabolic outcomes, such as hypertension.
AB - Background: Cardiovascular disease is a leading economic and medical burden in the United States (US). As an important risk factor for cardiovascular disease, hypertension represents a critical point of intervention. Less is known about longitudinal effects of neighborhood deprivation on blood pressure outcomes, especially in light of new hypertension guidelines. Methods: Longitudinal data from the Dallas Heart Study facilitated multilevel regression analysis of the relationship between neighborhood deprivation, blood pressure change, and incident hypertension over a 9-year period. Factor analysis explored neighborhood perception, which was controlled for in all analyses. Neighborhood deprivation was derived from US Census data and divided into tertiles for analysis. Hypertension status was compared using pre-2017 and 2017 hypertension guidelines. Results: After adjusting for covariates, including moving status and residential self-selection, we observed significant associations between residing in the more deprived neighborhoods and 1) increasing blood pressure over time and 2) incident hypertension. In the fully adjusted model of continuous blood pressure change, significant relationships were seen for both medium (SBP: β = 4.81, SE = 1.39, P =.0005; DBP: β = 2.61, SE = 0.71, P =.0003) and high deprivation (SBP: β = 7.64, SE = 1.55, P <.0001; DBP: β = 4.64, SE = 0.78, P <.0001). In the fully adjusted model of incident hypertension, participants in areas of high deprivation had 1.69 higher odds of developing HTN (OR 1.69; 95% CI 1.02, 2.82), as defined by 2017 hypertension guidelines. Results varied based on definition of hypertension used (pre-2017 vs. 2017 guidelines). Conclusion: These findings highlight the potential impact of adverse neighborhood conditions on cardiometabolic outcomes, such as hypertension.
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U2 - 10.1016/j.ahj.2018.07.005
DO - 10.1016/j.ahj.2018.07.005
M3 - Article
C2 - 30092412
AN - SCOPUS:85050969474
SN - 0002-8703
VL - 204
SP - 109
EP - 118
JO - American heart journal
JF - American heart journal
ER -